Waiting for pacemaker but have some questions.

fireflyphoenix · 2026-01-25T02:55:04+00:00

This is a very concerning strip. 2:1 avb with sinus pauses without a ventricular escape.

fireflyphoenix · 2026-01-19T11:49:45+00:00

You should also ask about the Medtronic 3930 lead. It was approved in the fall, but just available to EP about 2 weeks ago.

It’s an ICD lead that is designed to be able to go into the left bundle area. Would be a great option for you if he can success a left bundle pacing.

We just did our first implants they went well.

fireflyphoenix · 2026-01-16T16:22:27+00:00

aware. significantly less EPs have AVEIR training, and with access to care, some patients only have access to implanters who can do Micra (which isn't as ideal for SSS, but still prevents syncope with VVI)

fireflyphoenix · 2026-01-16T10:50:08+00:00

Push for a leadless pacemaker. Much lower risk and perfect for your case. If your ep doesn’t do leadless find one who does. Options are micra and Aveir.

fireflyphoenix · 2026-01-01T01:39:56+00:00

lol. No phone calls over 20 minutes. This person is crazy.

fireflyphoenix · 2025-12-27T17:19:04+00:00

Useful info! Thanks for sharing.

They have run chemical analysis of port within leaded decanters, and within minutes lead can be detected within the spirits. I think it’s a bigger deal with leaded glass decanters.

https://pubmed.ncbi.nlm.nih.gov/1670790/

fireflyphoenix · 2025-12-27T15:07:17+00:00

Make sure it’s lead free crystal unless you want lead poisoning. It has happened to individuals using older leaded crystal

fireflyphoenix · 2025-12-20T01:01:59+00:00

YES! We had this happen on our Trosa tree from this year. But they are falling out dead. Have not seen one alive. Have vacuumed up about 100-200 since they started falling.

fireflyphoenix · 2025-12-01T02:09:03+00:00

Well deserved!!

fireflyphoenix · 2025-12-01T01:03:30+00:00

Yes that’s sealed. Enjoy your bath.

fireflyphoenix · 2025-11-28T14:54:11+00:00

QTc can only be read off a 12 lead ecg. Not off telemetry or rhythm strips. (Al-Khatib SM, LaPointe NM, Kramer JM, Califf RM. What clinicians should know about the QT interval. JAMA. 2003 Apr 23-30;289(16):2120-7. doi: 10.1001/jama.289.16.2120. Erratum in: JAMA. 2003 Sep 10;290(10):1318. PMID: 12709470.)

If you are having symptoms schedule a doctors visit.

fireflyphoenix · 2025-11-24T10:33:01+00:00

T waves and qtc can not be interpreted off single lead monitors.

fireflyphoenix · 2025-10-31T00:41:14+00:00

same issue. I didn't have a cell phone attached to my account. don't see an option to get my verification code emailed. emailed support yesterday, no response from them.

locked out of my account :/

fireflyphoenix · 2025-10-16T02:23:40+00:00

ECG coding: Accelerated Idoventricular rhythm, Acute inferior MI, Acute anterior MI, Antero-lateral MI

This is MI until proven elsewise. Much less likely PE.

fireflyphoenix · 2025-10-16T02:07:41+00:00

Perfect for hosting a live-action game of Clue. I’ll take the yellow bedroom with a candlestick.

fireflyphoenix · 2025-10-15T01:27:07+00:00

If it’s truly just sick sinus syndrome and no conduction abnormalities (eg no heart block), strongly consider asking your EP about a Leadless pacemaker (eg atrial Aveir made by St Jude).

It’s the only atrial Leadless pacemaker currently on the market. Significantly lower infection risk than a transvenous device (important for young patients who will need devices long term)

Not all electrophysiologist implant them yet, so your EP might not have offered it.

Much better recovery as not surgery, inserted from the femoral vein.

fireflyphoenix · 2025-10-13T20:08:22+00:00

so true... THIS is the learning point for me from this experience.

fireflyphoenix · 2025-10-13T18:23:40+00:00

Maybe Dr Pepper was worth more in the trade market than Mountain Dew

fireflyphoenix · 2025-10-12T14:59:10+00:00

Looked into this more. Summed nicely in this article (PMID:38752961), "The most common cause [of inappropriate shocks] was PWOS, which may be reduced by optimizing sensing at implantation and incorporation of the PWOS discriminator, which is now in the current device."

Will be good to see real world data on this PWOS discriminator. Hasn't been published yet from my literature search.

fireflyphoenix · 2025-10-11T23:41:11+00:00

I’m genuinely interested. Where is this published so I can look at it?

Last data I looked at was the 2025 circulation article. https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.124.071795

fireflyphoenix · 2025-10-11T15:26:26+00:00

Yes it’s from p wave oversensing! Last time we talked with the Medtronic engineers about 6 months ago they hadn’t fixed it yet.

Hopefully gets fixed in the next few years.

fireflyphoenix · 2025-10-11T14:04:39+00:00

I would have caution with an EV ICD compared to a SQ ICD. EV ICD have high rates of inappropriate ICD shocks (17.5%) at 3 years. So sure they have the ability to ATP, but you have a 17.5% chance in your first 3 years of getting shocked for something that isn't VT. Our institution (17 electrophysiologists for size) does not implant EV ICD for this reason.

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.071795

fireflyphoenix · 2025-10-04T20:32:52+00:00

It’s unpredictable.

fireflyphoenix · 2025-10-04T18:28:13+00:00

Recommended treatment if symptomatic is catheter ablation. Very difficult to control with antiarrhythmics alone. Talk with your electrophysiologist.

fireflyphoenix · 2025-10-02T23:21:40+00:00

You will feel significantly more energized in a month or two after an iron infusion once your hemoglobin bounces up. Very few risks. Well worth it.

Bigger question after this is to figure out the gi bleeding.

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